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Article

What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use

by
Abigail T. Evans
1,*,
Katherine C. Henderson
2,*,
Anna Geier
1,
Scott R. Weaver
2,
Claire Adams Spears
2,
David L. Ashley
2,
Meredith Fritz
1,
Lisa John
1 and
Terry F. Pechacek
2
1
Battelle Memorial Institute, Baltimore, MD 21209, USA
2
School of Public Health, Georgia State University, Atlanta, GA 30303, USA
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(23), 8865; https://doi.org/10.3390/ijerph17238865
Submission received: 30 October 2020 / Revised: 20 November 2020 / Accepted: 25 November 2020 / Published: 28 November 2020
(This article belongs to the Special Issue Perceptions of Tobacco and Nicotine Products)
Versions Notes

Abstract

Switching completely from cigarettes to electronic nicotine delivery systems (ENDS) may reduce health risks for addicted smokers. This paper provides information about perceptions and other factors that may influence smokers’ ENDS use and substitution for cigarettes. We conducted 12 online focus groups (N = 61) among smokers who had never tried using ENDS (Never Users, N = 11), currently used both cigarettes and ENDS (Dual Users, N = 21), used but discontinued ENDS (Rejectors, N = 14), and switched completely to ENDS use (Switchers, N = 15). Thematic analysis was used to interpret the transcripts. Participants described initial interest in trying ENDS in hopes of quitting smoking and because of convenience (i.e., due to rules, regulations, or social norms). Risk perceptions and higher prices relative to cigarettes were reported as disadvantages of ENDS that discouraged initiation. Dual Users and Rejectors reported product problems (e.g., products breaking) and dissatisfaction (i.e., inability to satisfy cravings for cigarettes) as factors that lowered their substitutability for cigarettes or led to discontinuing ENDS use. Switchers indicated that satisfaction, lack of product problems, and perceived safety facilitated successfully switching from cigarette smoking to exclusive ENDS use. However, Switchers reported trying many products before they found ones that satisfied their needs. We recommend that policymakers consider the potential impact of tobacco control policies on smokers’ motivation and ability to switch completely from cigarettes to ENDS.
Keywords: electronic cigarette; decision making; motivation; focus groups; dual use electronic cigarette; decision making; motivation; focus groups; dual use

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MDPI and ACS Style

Evans, A.T.; Henderson, K.C.; Geier, A.; Weaver, S.R.; Spears, C.A.; Ashley, D.L.; Fritz, M.; John, L.; Pechacek, T.F. What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use. Int. J. Environ. Res. Public Health 2020, 17, 8865. https://doi.org/10.3390/ijerph17238865

AMA Style

Evans AT, Henderson KC, Geier A, Weaver SR, Spears CA, Ashley DL, Fritz M, John L, Pechacek TF. What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use. International Journal of Environmental Research and Public Health. 2020; 17(23):8865. https://doi.org/10.3390/ijerph17238865

Chicago/Turabian Style

Evans, Abigail T., Katherine C. Henderson, Anna Geier, Scott R. Weaver, Claire Adams Spears, David L. Ashley, Meredith Fritz, Lisa John, and Terry F. Pechacek. 2020. "What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use" International Journal of Environmental Research and Public Health 17, no. 23: 8865. https://doi.org/10.3390/ijerph17238865

APA Style

Evans, A. T., Henderson, K. C., Geier, A., Weaver, S. R., Spears, C. A., Ashley, D. L., Fritz, M., John, L., & Pechacek, T. F. (2020). What Motivates Smokers to Switch to ENDS? A Qualitative Study of Perceptions and Use. International Journal of Environmental Research and Public Health, 17(23), 8865. https://doi.org/10.3390/ijerph17238865

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